A Family Outbreak of Foodborne Botulism Following Consumption of Home-Canned Doogh in Hamadan, West of Iran

Background: Food-borne botulism is one of the potentially fatal forms of food poisoning, usually caused by ingestion of home-canned vegetables, fruits and fish products. Objectives: The aim of this study was to report an outbreak of botulism due to homemade doogh in Hamadan, Iran. Patients and Methods: During an outbreak, ۱۰ members of a family referred to the hospital because of food poisoning. All patients had a history of consumption of doogh, a traditional drink. After careful physical examination, all of them were hospitalized. Botulism was suspected in all patients except for the first patient. Results: The first patient was a ۷۶-year-old man who died after ۱۲ hours of admission due to respiratory distress. Nine subsequent patients were diagnosed as botulism with the following symptoms: diplopia (۹۰%), dizziness (۷۰%), nausea and vomiting (۸۰%), ptosis (۶۰%), symmetric weakness of extremities (۶۰%), dysarthria (۳۰%), chest discomfort (۳۰%), mydriasis (۲۰%), dysphasia (۲۰%) and dry mouth (۲۰%). All of the nine patients received botulinum antitoxin and improved during ۵-۱۵ days of hospitalization. Conclusions: Immediate diagnosis based on careful history and physical examination are essential for management of botulism. People should be notified about proper food handling and preparation of traditional homemade foods.